Monthly Archive for April, 2008

The Slippery Slope of Drug Addiction

drug paraphernaliaToday, I’d like to touch upon a subject that I think in some way affects us all.  I’m talking about the continually unfolding disaster of substance abuse in this country.

As a physician, I see the effects of drug addiction and abuse on pretty much a daily basis.  There is hardly a day goes by that I don’t have at least one person either come in to the clinic or call my nurse demanding I write a prescription for their favorite controlled substance.  I typically politely decline.

The problem is certainly not confined to prescription medications either.  Currently the big problem in this neck of the woods seems to be related to methamphetamine, though crack coccaine is pretty big around here too.  None of this is meant to ignore other substances.

After a while, you sort of get a sixth sense about these folks and can usually spot them pretty easily.  A lot of times, I can spot them before I even see them, simply from what is written in the chart, what their presenting complaint is and how it is worded.

The E.R. docs have an even greater exposure to this stuff than I do as a family medicine doc.

It doesn’t take long for most folks in the medical profession to become somewhat cynical towards these patients.  Hang out with some doctors or nurses long enough and you’re almost certain to hear them complain about their latest drug-seeker, or that disruptive crack-head they saw the other day, etc.

I’m not immune to this either.  The fact of the matter is that a lot of these patients genuinely are a disruptive pain-in-the-asses.  They usually take up an inordinate amount of time trying to convince you to do something you’ve already told them you won’t.  They are often quite rude, and often use foul, abusive, and occassionally threatening language.

It’s not hard to lose sight of the fact that in spite of all this, they are still people.  Most of them have family who love them and are worried about them.  Most of them have dreams and aspirations.  Most of them did not spend their early childhood dreaming of someday being an addict.

I’m not some touchy-feely left-wing pansy trying to make excuses for them or condone their behavior.  What they are doing is wrong.  They need to stop.  They need help.  Unfortunately, they are not usually too interested in receiving any help.  They usually just want that next hook-up.

What got me going on this subject today was something I read from a member of another internet forum I sometimes visit.  The guy posting this put a different light on the addict than what we usually see.

His is a story that I felt should be shared.  I asked his permission to post it here and he kindly gave it.

Here goes.

” Truthfully, I do have some sympathy towards addicts. my only experience with a crackhead/crackwhore.. My ex-wife’s younger sister, she was 16 or 17 at the time, and my ex wasn’t my ex yet.

Sis was dating a slightly older guy, seemed pretty nice. Parents were parents, they weren’t pleased that she was dating, but that’s what having a daughter is all about. When they met him, he said all the right things.

A little dating, a little experimentation with drugs (pot, ecstasy) apparently resulted in her to going to a party with him and people that she didn’t know. He got her high, and then gave a her a little crack. Over the next few weeks, he gave her a little more and a little more. just led her down the trail to addiction. all free, nobody suspected a thing.

She got hooked, then he wanted her to pay for her habit. She emptied her piggy bank, she emptied her bank account, not enough. Small things disappeared around the in-laws house. They didn’t notice.

They noticed her change in behavior, she was irritable (okay, more irritable), she was defensive, she wasn’t home. They didn’t know yet that she quit her job. Joe Blow kept giving her crack (discounted prices). She was hooked.

She stole more, she gave away her car, parents reacted wrongly (tried to confine her to house, gated community), and then they kicked her out. Instantly regretted that, but then they couldn’t find her to bring her back and get her proper help. They didn’t yet realize what was going on, just attributed it to her going through some rebellious stage.

She had no more money, she had no access to money. Joe Blow became her pusher and her pimp. all of this in less than a month.

Parents found her, brought her home, tried to get her help. a week or two later, she emptied mom’s very expensive jewelry case (after breaking into a locked room) and disappeared again.

Two weeks later they found her again, , in this short period of time she went from a beautiful young woman to an emaciated, much older looking, worn-out person.

This time, they put her in a program, in a home.

I was there to see their anguish throughout the entire ordeal. I helped them search the streets, try to keep her company when she was home, visit her in the rehab center. She did manage to overcome her addiction, but afterwards she was devestated.

She knew what she had done, the whole family needed counselling (but they didn’t get it, which was surprising to me). The last that I heard from her, she had her life back under control and was going to college. But she was scared about how she’d react in new situations with less help. She did join NA and hopefully everything has gone well for her since.

So, I can feel sympathy for addicts. Sis and her family had everything, loving, close-knit family, very secure financially, and this still happened, and was hard as hell to reverse..”

More On Spam (or should I say Moron Spam?)

Turkey SpamThis is a pretty new blog and I am a relatively very new blogger.

When I started this website and blog, one of my main goals was to simply expose myself to this cyber-world and get some experience and learn a bit about creating internet content.

Many/most of my blog posts have been excessively wordy, but I realize that this is part of my learning experience. All of them have been heartfelt. All of them represent countless hours of research and work.

As with most new blogs, my internet traffic has been less than stellar. This hasn’t really surprised me too much.

I read one statistic that stated that there are approximately 175,000 new blogs started every day. So, I know that no matter how great a writer I might be (which I know I am not), it’s going to take some time to get any sort of meaningful traffic.

So, with all that in mind, I must say that I was somewhat amused with my most recent post which I put up a little over a week ago. It was the one titled Fax Spam in which I briefly talked about an annoying though somewhat humorous fax I received advertising some sort of male sexual enhancement product being sold at the website

Of all my posts, this was the one I put the least effort or thought into. It was just a brief little blurb I typed out in about 10 minutes for fun.

Wouldn’t you know, it has garnered more traffic so far than all my other posts combined.

My traffic is still certainly pathetic, but this was a real head-shaker.

The most fun part of the whole thing was in the comments section of that post. I have learned that there are definitely some real loons out there in internet land.

Anyway, I thought I’d try a little experiment here and provide a small sample of the email spam I have received today just to see what happens.

If you are reading this, then thanks for your participation in this experiment in human behavior.

Here goes.

This first one is a spam email I received from “Anita Kaiser“. It’s subject line is titled BEST PRICE ! Buy Cialis, Viagra online NOW – and save 50% your money !!!

The body of the email reads as follows.

Hello !

Now you have the opportunity to save your time and money!

With US based online p,h,a,r,m,a,cy store you can buy any meds you

Forget about p/r/e/s/c/r/i/p/t/i/o/n/s and doctors. Now you save your

Forget about high prices at local stores.

M/e/n/’s H/e/a/l/t/h
A/n/t/i – D/e/p/r/e/s/s/a/n/t/s
P/a/i/n R/e/l/i/e/f
W/e/i/g/h/t l/o/s/s

Go visit:


Next in our experiment is the following spam email I received today from “Ernest Calloway“, though his return email address is

By the way Brian, if my publishing of your email address generates some spam for you, well you know, Karma.

Anyway, the title of Brian’s, er I mean “Ernest’s” email is “re: (no subject)

Ooh, now that’s original. Hey, do you think he was trying to fool me into thinking he was actually responding to an email I sent him? Oh Ernest, you’re so clever!

Anyway, the body of his email reads as follows.

Hey, want to get those bills under control for good, it’s easier than you think. We will help you.

Go here this is your solution.

Now, after “Ernest’s” scintillating email, I was really looking forward to the next one which looked suspiciously familiar. Its subject line was very similar to the one Ernest sent. It was simply titled “(no subject)” and was sent to me by Louise Hinson. Interestingly, like Ernest above, her email address,, didn’t really seem to match up with her name.

Oh and Sara, that Karma thing applies to you as well.

The body of her message is where she and Ernest bore the most striking resemblance however and it was as follows.

Hey, want to get those bills under control for good, it’s easier than you think. We will help you.

Go here this is your solution.

So these are three little slices of spam I’ve dined on today and thought I’d share them with you. I’m curious to see what sort of response they generate.

Let’s see!!



Fax Spam

Fax SpamWow.  This was a new one for me.

About 20 minutes ago, this came over the fax machine at my clinic.

I know the picture quality isn’t so good as I took the pic with my cell phone camera, so I’ll type what is written.

It is a fax from LBI, INC. of Toronto, Canada and was sent by “Tod

The subject is “Re: our last conversation

Under the comments section it says

“Sorry, my cell battery went on me.

The pills I use Work Better than Viagra & you don’t need a prescription because it’s herbal.  That alone saves you $100 for a doctor visit.

This website gives out FREE samples


I’t very, very effective, you’ll be happy you tried it.  The Free Sample offer can end anytime so I’d get it now while you can.”

For what it’s worth, I don’t know Tod, nor have I had any cell phone conversations with him.

At the risk of revealing too much information, I will also state here for the record, that I have no personal need for any product of this sort.  The plumbing is still fully functional so far!

I know a lot of folks routinely receive this sort of spam via email on a regular basis. This is the first time I’ve ever received any via the fax machine, however.

Since I am the only male working in my clinic, the girls all had a good laugh and told me that this fax was obviously for me.

I’d sure like to know who gave Tod our fax number.

You can’t really see it in the picture above, but Tod has wisely blocked his number from appearing on the fax copy.

Anyway, hope you all have a laugh at this, and I hope this isn’t the first in a new wave of spam.

On a positive note however, perhaps this is just the sort of thing to drag the medical profession kicking and screaming into the 21st century and convince us all to get rid of the fax machines.



In a Vial, Crocodile

SchnappiI saw a sort of neat story on the BBC News website about researchers in Louisiana who are taking proteins from alligator blood and trying to use them to develop new antibiotics.

Other than handbags and good eating, alligators are mostly just a bit of a nuisance in these parts.

I think it would be great if these researchers are successful in their quest.

Of course, natural selection being what it is, I’m sure that MRSA (Methicillin Resistant Staphylococcus Aureus) would likely eventually evolve into GRSA (Gator Resistant Staph Aureus).

By the way, the picture above of the little alligator is one I took back in 2003 at the Dauphin Island Sea Lab Estuarium.

He always sort of reminded me of Schnappi, the darling of German MTV, when my wife and I were living over there in 2004-2005.

(Oh, and before some smarty-pants feels the need to correct me, I do know the difference between alligators and crocodiles, but “See ya later, alligator” didn’t seem nearly as original for the title of this post.)

It’s a Teenage Wasteland

Teenage wastelandI think I’ve mentioned it before in other posts in this blog, and I tell it to my patients all the time. It bears repeating here.

The overwhelming majority of the stuff I tell my patients when it comes to staying healthy doesn’t require the letters “M” and “D” after one’s name.

Most of this stuff is basic common sense that the average fifth grader knows. Eat your vegetables, get enough sleep, exercise, don’t smoke, don’t do drugs, don’t sleep around with scuzzy strangers, etc., etc., etc.

I’d say probably 95% of what I do as a family physician falls into this category. (Now that other 5% however, well, that’s a different story. That other 5% represents years and years of hard work in medical school and residency and clinical practice experience.)

Anyway, there was an interesting article in the April issue of the journal Pediatrics titled Characteristics Associated With Older Adolescents Who Have a Television in Their Bedrooms.

The conclusions in this article seem to fit very nicely into my 95% “Duh, a fifth grader could tell you that,” category.

Basically, they compared older teenagers who had televisions in their bedrooms with those who did not.

In the words of Gomer Pyle, “Surprise, surprise, surprise!”

What they found was that those with televisions in their bedrooms tended to watch more television, have less physical activity, lousier eating habits, etc.

So parents, here’s a no-brainer for you: Do your kid a favor and get the television out of their bedroom.

Okay, so now here’s an even bigger no-brainer for you. Get the damn boob-tube out of your own bedroom as well.

Want to take it even a step further? Get the darned thing out of your house altogether.

Okay, I realize that may be too big a step for most folks. If it’s too big a step for you, then at least turn it off once in a while and go get some exercise.

(In the interest of full disclosure, I will say that my wife and I do have a television in our living room, but we almost never watch it. We used to have cable service, but we decided to have it disconnected about a year ago. We don’t have any sort of antenna and therefore we have absolutely no channels to watch.

I have to say, I’ve never been happier. We are saving money by not paying a cable bill and our lifestyle is much healthier. We eat better, exercise more, read more, interact with each other more, you name it. We do occasionally rent a movie and watch it, but our television otherwise remains off. We have no intention of ever going back!

I highly recommend this to anyone reading this blog.)



Hands Only Cardiopulmonary Resucitation (CPR)

L’Inconnue de la SeineThere was an interesting story on MSNBC.COM about hands-only CPR.

As a physician, every two years I get re-certified in Basic Life Support (BLS), which is essentially what most folks know as CPR,  as well as Advanced Cardiac Life Support (ACLS), which is essentially what they try to portray in shows like “E.R.” when everyone is dramatically yelling  stuff like “Give him an amp of epi, stat!”.

Since finishing residency, I no longer practice any obstetrics (for reasons discussed in my medical liability and malpractice reform blog post), so I no longer get re-certified in Advanced Life Support in Obstetrics (ALSO).

I have never gotten certified in Advanced Trauma Life Support (ATLS), which is something that the surgeons and ER docs all get certified in. I don’t do ER medicine, so I haven’t really been able to justify the extra expense and time involved with getting this certification. I keep thinking perhaps I will get it someday though, as moonlighting in the local ER may be something I’d like to pursue in the future.  For now though, I’ll leave the chest tubes and tracheotomies and such to others. Continue reading ‘Hands Only Cardiopulmonary Resucitation (CPR)’

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